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10.8: The Nursing Leader's Role in Managing Organizational Change

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  • The nurse leader’s role as change agent is complex and varied in nature, and it represents significant leadership challenges. Innovative organizational change can be effectively managed with proven leadership strategies and tools (MacPhee, 2007). The change agent has two main responsibilities: to change oneself and to build capacity in others. Stefancyk et al. (2013) introduced the idea of a change coach, which builds upon the traditional role of a nurse leader. A change coach or leader uses coaching behaviours that include guidance, facilitation, and inspiration (Stefancyk et al., 2013). The leader uses guidance to set behavioural expectations for staff performance and provides feedback on performance in the change project. As a facilitator, the change coach encourages staff to share in decision making, thereby creating and nurturing a culture that supports input from others, facilitates creative thinking, and enhances the process of finding the best solutions to address challenges. The leader takes on an inspirational role, expressing confidence and recognizing staff as providing meaningful contributions to the change process.

    Building partnerships with staff that include two-way communication, both internally and externally, is critical to building trust and teamwork (Gilley et al., 2009; Yukl, 2013). Communication strategies can include informing those affected by the change how the change will affect their job, and providing information in a timely manner to help them make effective decisions. Nurse scholars (MacPhee, 2007; Morjikian, Kimball, & Joynt, 2007; Stefanyk et al., 2013) suggest that developing trust is a component of communicating effectively, and that this can be accomplished through demonstrating approachability, building rapport, listening, and restating the opinions of others (even when the leader disagrees with the opinion). Listening to staff also means being aware of change fatigue, a condition experienced by individuals subjected to unrelenting and overwhelming change in their work environments (Bowers, 2011). Leadership and management skills and behaviours can positively influence the execution of change initiatives (Gilley et al., 2009).

    A call to action means the leader knows when strategies for change need to be altered to foster effective followership. Navigating complex organizational structures through formal and informal power networks is foundational to setting the stage for a successful change. Organizational agility requires the leader to know and understand how the organization works and to be familiar with key policies, practices, and procedures.

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